Prospective Study To Evaluate Device-Associated Nosocomial Infection Rates in Intensive Care Units in a Brazilian Public Hospital: Benchmark with NNIS American Rates

OBJECTIVES: To measure the incidence of device-associated nosocomial infections in ICU in Brazil and to compare with NNIS rates. METHODS: We performed a prospective nosocomial infection surveillance study during 3 months in two Brazilian ICUs of one public hospital. Nosocomial infections were identified using the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance (NNIS) system definitions, and site-specific nosocomial infection rates were calculated. RESULTS: We collected data on 171 patients, 670 bed days, 602 central vascular catheter days, 404 mechanical ventilator days, and 592 urinary catheter days. The overall nosocomial infection rate was 15.2% (26/171) and 38.8 per 1000 patient days (26/670). The most common site of infection was central venous catheter–related bloodstream infection (CBSI) (61.5%, 16/26), followed by ventilator-associated pneumonia (VAP) (23.07%, 6/26) and catheter-associated urinary tract infection (CA-UTI) (15.38%, 4/26). The CBSI rate was 26.57 per 1000 device days (16/602) (benchmark with NNIS rate, RR: 6.96; CI 95% 4.26–11.37; P=0.0000). The VAP rate was 12.37 per 1000 device-days (5/404) (benchmark with NNIS rate, RR: 1.41; CI 95% 0.59–3.40; P= 0.43). The symptomatic CA-UTI rate was 6.75 per 1000 device-days (4/592) (benchmark with NNIS rate, RR: 1.72; CI 95% 0.65–4.59; P= 0.27). CONCLUSION: When compared with NNIS rates, we found our CBSI rate was seven times NNIS rates, our VAP rate 1.4 times the NNIS rate, and our CA-UTI rate 1.7 times the NNIS rate. In Brazilian public hospitals, we need to develop interventions to reduce nosocomial infections, especially CBSIs.